INTEGRATIVE WELLNESS CENTER, LLC (NPI# 1801353735) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1801353735 |
| Entity Type | Organization |
| Organization Name | INTEGRATIVE WELLNESS CENTER, LLC |
| Practice Address |
12 Roosevelt Ave Mystic CT 06355-2809 |
| Mailing Address |
58 Pheasant Run Dr Gales Ferry CT 06335-2022 |
| Practice Telephone | 8605729566 |
| Mailing Telephone | 8602350314 |
| Enumeration Date | 2019-02-27 |
| Last Update Date | 2019-02-27 |
| Authorized Official Name | DR. LAURA A MUNRO (OWNER) |
| Authorized Official Telephone | 8602350314 |
| Authorized Official Credential | ND |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 175F00000X | Naturopath | Other Service Providers |
| Other Name | Type Code |
|---|---|
| Natura Medica | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861650301 | Integrative Wellness Center, LLC | Clinic/Center | 2343 Se 44th Ave, Portland, OR 97215-3721 | 2008-05-31 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Connecticut Business Registrations | Integrative Wellness Center, LLC | 58 Pheasant Run Drive, Gales Ferry, CT 06335 |
| Colorado Business Entities | INTEGRATIVE WELLNESS CENTER, LLC | 3980 Boradway Ste 103, Boulder, CO 80304 |
| Street Address |
12 ROOSEVELT AVE |
| City | MYSTIC |
| State | CT |
| Zip Code | 06355-2809 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114993789 | Thomas Jeffrey Wagner | Optometrist | 12 Roosevelt Ave, Mystic, CT 06355-2809 | 2006-02-24 |
| 1679107411 | Optimystic LLC | Optometrist | 12 Roosevelt Ave, Mystic, CT 06355-2809 | 2020-03-02 |
| 1972954477 | Mystic Medical Associates LLC | Counselor | 12 Roosevelt Ave, Second Floor, Mystic, CT 06355-2809 | 2016-06-27 |
| 1164896189 | Natura Medica | Naturopath | 12 Roosevelt Ave, Mystic, CT 06355-2809 | 2015-11-16 |
| 1992175038 | Ana Gabriella Ruediger | Naturopath | 12 Roosevelt Ave, Mystic, CT 06355-2809 | 2015-10-01 |
| 1669889820 | Christopher J Anderson | Nurse Practitioner | 12 Roosevelt Ave, Second Floor, Mystic, CT 06355 | 2014-07-18 |
| 1598105595 | Dialect Pyschotherapy Inc. | Marriage & Family Therapist | 12 Roosevelt Ave, Mystic, CT 06355-2809 | 2013-07-05 |
| 1205138161 | Susanne G Taylor | Marriage & Family Therapist | 12 Roosevelt Ave, Mystic, CT 06355-2809 | 2010-11-29 |
| 1174853691 | Anne Rivers | Social Worker | 12 Roosevelt Ave, Suite 203, Mystic, CT 06355-2809 | 2010-01-06 |
| 1548449119 | Deirdre J. O'connor, N.d. | Naturopath | 12 Roosevelt Ave, Mystic, CT 06355-2809 | 2007-10-30 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770076069 | Brian Kristofer Owczarski | Physical Therapist | 80 Stonington Rd Ste A-3, Mystic, CT 06355 | 2018-06-11 |
| 1922554120 | Kayla Nickerson Gauthier | Marriage & Family Therapist | 41 Williams Ave, Mystic, CT 06355 | 2016-08-28 |
| 1417351156 | Lisa Pacifico | Physical Therapist | 44 Maritime Dive, Mystic, CT 06355 | 2014-10-09 |
| 1619386539 | Jennifer Rock | Occupational Therapist | 44 Maritime Drive, Pendleton Health and Rehab Center, Mystic, CT 06355 | 2014-08-05 |
| 1346565843 | Karen Lucille Hanscom | Psychologist | 47 Water St. #203, Mystic, CT 06355 | 2010-03-29 |
| 1346415627 | Eldon Richard Kilpatrick | Physical Therapy Assistant | 186 Jerry Browne Rd, Mystic, CT 06355 | 2008-04-28 |
| 1760688931 | Heather Elyse Geyer | Physical Therapist | 2440 Gold Star Hwy Suite 201, Mystic, CT 06355 | 2007-06-25 |
| 1982728754 | Falck Eye Center LLC | Ophthalmology | 35 Washington Street, Mystic, CT 06355 | 2007-03-19 |
| 1881724326 | Richard Irwin Steinberg | Dentist | 117 Cow Hill Road, Mystic, CT 06355 | 2007-03-06 |
| 1992890362 | Coastal Dermatology, P.C. | Dermatology | 55 Willow Street, Mystic, CT 06355 | 2006-10-03 |
| Find all providers in zip 06355 | ||||
| Taxonomy Code | 175F00000X |
| Grouping | Other Service Providers |
| Classification | Naturopath |
| Diagnoses, treats, and cares for patients, using system of practice that bases treatment of physiological functions and abnormal conditions on natural laws governing human body: Utilizes physiological, psychological, and mechanical methods, such as air, water, light, heat, earth, phototherapy, food and herb therapy, psychotherapy, electrotherapy, physiotherapy, minor and orificial surgery, mechanotherapy, naturopathic corrections and manipulation, and natural methods or modalities, together with natural medicines, natural processed foods, and herbs and nature's remedies. Excludes major surgery, therapeutic use of x ray and radium, and use of drugs, except those assimilable substances containing elements or compounds which are components of body tissues and are physiologically compatible to body processes for maintenance of life. |
| Notes: Source: The Federal Dictionary of Occupational Titles, U.S. Department of Labor, Washington, D.C., section #079, 101-014 [7/1/2007: definition changed, source added] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164896189 | Natura Medica | Naturopath | 12 Roosevelt Ave, Mystic, CT 06355-2809 | 2015-11-16 |
| 1992175038 | Ana Gabriella Ruediger | Naturopath | 12 Roosevelt Ave, Mystic, CT 06355-2809 | 2015-10-01 |
| 1548449119 | Deirdre J. O'connor, N.d. | Naturopath | 12 Roosevelt Ave, Mystic, CT 06355-2809 | 2007-10-30 |
| 1902938020 | Stephanie Jo Draus | Naturopath | 12 Roosevelt Ave, Mystic, CT 06355 | 2007-03-12 |
| 1528141256 | Deirdre Joan Oconnor | Naturopath | 12 Roosevelt Ave, Mystic, CT 06355-2809 | 2006-10-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477152247 | Sarah Daglis | Naturopath | 126 Pershing Ave, New Britain, CT 06053-3551 | 2020-10-22 |
| 1427655422 | Tara Tranguch | Naturopath | 74 Main Street North, Bldg 2 - Apt 204, Woodbury, CT 06798 | 2020-10-03 |
| 1609482306 | Jessica Amelia Samaroo | Naturopath | 1700 Broadbridge Ave Unit C37, Stratford, CT 06614-5424 | 2020-09-17 |
| 1962016196 | Sarah Y Schindler | Naturopath | 12b Pasco Dr, East Windsor, CT 06088 | 2020-09-04 |
| 1225641632 | Brian Joseph Uss | Naturopath | 175 Rennell Dr, Southport, CT 06890-1491 | 2020-08-25 |
| 1568098861 | Jennah Bakke | Naturopath | 102 Norwich Rd, Salem, CT 06420-4001 | 2020-03-18 |
| 1649805730 | Emmeline Duong | Naturopath | 78 Olive St Apt 410, New Haven, CT 06511-6986 | 2020-03-09 |
| 1477185908 | Lisa Rose Trofa | Naturopath | 3 Hollyhock Rd Ste 2a, Wilton, CT 06897-4443 | 2020-02-12 |
| 1750922688 | Darisa Espinal | Naturopath | 75 Berlin Rd Ste 114, Cromwell, CT 06416-2633 | 2019-10-02 |
| 1629638267 | Dr Amanda Placeres LLC | Naturopath | 53 Bank St, New Milford, CT 06776-6708 | 2019-06-17 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.